CARE for COVID-19: A Checklist for Documentation of Coronavirus Disease 2019 Case Reports and Case Series.
Authors: Werthmann PG, Riley D, Kienle GS Abstract Coronavirus disease 2019 (COVID-19) is a new, rapidly spreading pandemic that can lead to a life-threatening disease. Accurate and transparent COVID-19 case reports provide systematic clinical observations supporting researchers designing clinical trials and clinicians delivering health care. The checklist described here is designed to systematically and accurately capture data from case reports and case series for documentation on COVID-19. It is aligned with the CARE guidelines, available from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research...
Source: The Permanente journal - September 23, 2020 Category: General Medicine Tags: Perm J Source Type: research

On the Use of Sampling Weights for Retrospective Medical Record Reviews.
This article aims to fill that gap and to demonstrate why the use of sample weights ought to be another best practice to add to the list by reviewing well-known theoretical details and some published data analysis examples. PMID: 32663124 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - July 15, 2020 Category: General Medicine Tags: Perm J Source Type: research

Endocrine Tumor Board: Ten Years' Experience of a Multidisciplinary Clinical Working Conference.
CONCLUSION: Patients with endocrine tumors may benefit from a specialized approach to care. A multidisciplinary tumor board can focus discussions efficiently, provide a forum to advance care, apply endocrine-related clinical guidelines, and lead to recommendations that clinicians often employed. PMID: 32663125 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - July 15, 2020 Category: General Medicine Tags: Perm J Source Type: research

Shorelines.
Authors: Niburski K PMID: 32663126 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - July 15, 2020 Category: General Medicine Tags: Perm J Source Type: research

The Insomnia Plague in Fictional Macondo.
This article examines the insomnia plague described in the novel One Hundred Years of Solitude and performs a differential diagnosis exercise with conditions that affect both sleep and memory. The main finding is that the insomnia plague narrated by García Márquez, with its clinical manifestations, the sequence of symptoms, and its resolution, cannot be associated with any specific diagnosis. However, similarities to and differences from several clinical conditions are discussed, as well as the relation between the neurophysiologic phenomena of sleep and memory. PMID: 32663127 [PubMed - as supplied by pub...
Source: The Permanente journal - July 15, 2020 Category: General Medicine Tags: Perm J Source Type: research

Treatment of Intertrochanteric Femur Fractures with Long versus Short Cephalomedullary Nails.
CONCLUSION: These findings suggest that routine use of short cephalomedullary nails is safe and effective in the treatment of intertrochanteric fractures. PMID: 32663128 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - July 15, 2020 Category: General Medicine Tags: Perm J Source Type: research

Bilateral Quadriceps Tendon Repair with Suture Anchors: Case Series.
DISCUSSION: These quadriceps tendon ruptures occurred in patients with a predisposition to injury as a result of excessive weight bearing. When addressing bilateral quadriceps tendon ruptures in this patient population, we found that a suture anchor-based construct allows for a secure repair, early initiation of physical therapy, and a noted improvement in pain scores on the Visual Analog Scale. PMID: 32589576 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - June 28, 2020 Category: General Medicine Tags: Perm J Source Type: research

Breast Cancer: Lifestyle, the Human Gut Microbiota/Microbiome, and Survivorship.
Authors: Bodai BI, Nakata TE Abstract Patients with a current diagnosis of breast cancer are enjoying dramatic cure rates and survivorship secondary to an increase in awareness, earlier detection, and more effective therapies. Although strategies such as Breast Cancer Awareness Month in October focus on early detection, lifestyle changes are seldom discussed other than dietary concerns and physical activity. Lifestyle modifications centered on diet and exercise have been demonstrated to affect overall disease-free survival in breast cancer. Since the early 2000s, the role of the human gut microbiota and its relatio...
Source: The Permanente journal - June 28, 2020 Category: General Medicine Tags: Perm J Source Type: research

Narrating the Cycle of Life.
Authors: da Conceição TV, de Oliveira GG Abstract Narrative medicine (NM) is an approach that values the patient's narrative about his/her disease as central to the clinical encounter and helps doctors to be more attentive to their patients' perspectives in the diagnostic and therapeutic process. A curricular change enabled a greater insertion of the humanities in the curriculum of the Faculty of Medicine of the University of Brasília in Brasília, Brazil. In this context, NM was incorporated into one of the disciplines of the third semester. During the semester, students are encouraged t...
Source: The Permanente journal - June 28, 2020 Category: General Medicine Tags: Perm J Source Type: research

Assessing Perception of Patients and Physicians Regarding Spirituality in Karachi, Pakistan: A Pilot Study.
DISCUSSION: Many health care professionals are hesitant to discuss spiritual issues with patients because of lack of time, insufficient training, or their own discomfort. There is a need to incorporate training about spirituality in the medical curriculum, especially in religious societies such as in Pakistan. Further research is needed in this area. PMID: 32589579 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - June 28, 2020 Category: General Medicine Tags: Perm J Source Type: research

Redressing Underrecognition of "Cold Drink Heart": Patients Teaching Physicians about Atrial Fibrillation Triggered by Cold Drink and Food.
Redressing Underrecognition of "Cold Drink Heart": Patients Teaching Physicians about Atrial Fibrillation Triggered by Cold Drink and Food. Perm J. 2020;24: Authors: Vinson DR Abstract In this essay I tell the story of insightful patients from around the world with cold-drink atrial arrhythmias, particularly atrial fibrillation (AF). This common condition has received little research attention and remains unknown to many physicians. The under-representation of "cold drink heart" in the literature led me and a colleague a few years ago to publish a case report on this topic in an ope...
Source: The Permanente journal - June 28, 2020 Category: General Medicine Tags: Perm J Source Type: research

Evaluation of the Learning to Integrate Neighborhoods and Clinical Care Project: Findings from Implementing a New Lay Role into Primary Care Teams to Address Social Determinants of Health.
CONCLUSION: Adding an individual to the primary care team with expertise in community resources can increase patient satisfaction, support clinicians, and improve patients' perceptions of their health and well-being. PMID: 32392126 [PubMed] (Source: The Permanente journal)
Source: The Permanente journal - May 13, 2020 Category: General Medicine Tags: Perm J Source Type: research

Fostering Partnerships with the Safety Net: An Evaluation of Kaiser Permanente's Community Ambassador Program in the Mid-Atlantic States.
CONCLUSION: The Community Ambassador Program achieved its goals and had clear benefits, offering a model for large health care systems wanting to collaborate with community-based clinics. Careful planning is needed to ensure that positive results are sustained. PMID: 32240080 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Pharmacist Medication Management of Adults with Attention Deficit: An Alternative Clinical Structure.
CONCLUSION: We believe this program offers a solution to a component of this growing problem, and other clinical sites would benefit from such a program. Next steps include analysis and publication of results of implementation, including patient outcomes, engagement in treatment, and satisfaction. PMID: 32240081 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Drug-Induced Lupus, a One-time Hit or a Harbinger of Future Autoimmunity: A Case Report.
DISCUSSION: Our case highlights how DIL should be on the differential when seemingly disparate symptoms develop in a patient receiving DIL-associated medications. Lupus is one of the "great imitators," in which symptoms can be ascribed to many different underlying causes. Although this patient's presentation may have been confounded by concomitant histoplasmosis, his improvement with cessation of hydralazine treatment argues in favor of DIL. His continued atypical serologic test results could be residual from his DIL and should normalize with time. However, it raises the question whether this bout of DIL has unma...
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

"Lifeboat".
"Lifeboat". Perm J. 2020;24: Authors: Caplin A PMID: 32240083 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Working to Achieve the Quadruple Aim - Abstracts from the Kaiser Permanente 2020 National Quality Conference.
Authors: Gin N, Courneya P Abstract Quality improvement activities are essential to achieving the Institute for Healthcare Improvement's Quadruple Aim of improving the health of our patients and members, enhancing members' care experiences, reducing costs, and attaining joy and meaning for our physicians and care teams in the workplace. These activities are also essential in creating a learning health care system. PMID: 32240084 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Capturing Risk Associated with Childhood Adversity: Independent, Cumulative, and Multiplicative Effects of Physical Abuse, Sexual Abuse, and Family Violence on Mental Disorders and Suicidality.
CONCLUSION: Future work should examine a comprehensive set of ACEs to identify which ACE combinations contribute to greater mental health burden, thereby informing the development of specific interventions. PMID: 32240085 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Addressing the Health Needs of the Uninsured: One Community's Solution.
CONCLUSION: Safety-net clinics such as Volunteers in Medicine are a needed and viable option to the provision of health care to the vulnerable, often unseen members of society. PMID: 32240086 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Primary Renal Carcinoid Tumor: Report of Two Cases.
This report describes 2 cases of primary renal carcinoid tumor with unique presentations and management in our regional health care system. Because primary renal carcinoid tumors are quite uncommon, there are no clear established guidelines on preoperative imaging or posttreatment surveillance in patients with these tumors. There remains a large amount of variability in the diagnosis, workup, immunohistochemical analysis, treatment, and surveillance of patients with primary renal carcinoid tumors. As we learn more about this disease, we hope to optimize patient outcomes and standardize pretreatment workup and posttreatment...
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Rapid Induction Therapy for Opioid-Use Disorder Using Buprenorphine Transdermal Patch: A Case Series.
We present a case series involving a novel approach to the induction phase of buprenorphine or buprenorphine-naloxone therapy using transdermal buprenorphine. This approach has been demonstrated in inpatient settings but has not been widely explored in the outpatient setting. We demonstrated that a range of patients, from the highly medically complex to relatively straightforward cases, benefited from this approach. DISCUSSION: We believe that this approach can be used in a wide range of patients to transition from opioid use to buprenorphine therapy without the patient having to experience withdrawal or wait to start ...
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Comprehensive Outpatient Management of Low-Risk Pulmonary Embolism: Can Primary Care Do This? A Narrative Review.
CONCLUSION: Until studies establish safe parameters of such a practice, the question "Can primary care do this?" must remain open. PMID: 32240089 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Primary Functioning Neuroendocrine Tumor of the Appendix with Hypoglycemia Syndrome: A Case Report and Review of Neuroendocrine Tumors.
DISCUSSION: A literature review demonstrates no other case series or reports of a primary hyperfunctioning NET of the appendix presenting with hypoglycemic crisis. The symptoms of tumor-induced hypoglycemia more typically arise with islet cell tumors, such as pancreatic NETs or insulinomas. We believe this case represents a nonislet cell tumor-induced hypoglycemia. This patient's elevated serum proinsulin level preoperatively implies secretion of proinsulin by the tumor. However, tumor-induced hypoglycemia caused by proinsulin has been described previously only in pancreatic tumors. This unique case adds knowledge to the p...
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

My Footsteps on the Floating Dock.
Authors: Parchman M PMID: 32240091 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

Let's Care for Those in Need-Today: Collaborating to Solve the Uninsured Crisis in America.
Authors: Jacobs L Abstract This editorial is a call to action for medical communities across the country to address the uninsured crisis in their communities. Thirty million Americans without insurance need access to affordable, high-quality care. An insurance solution may be years away, so we must start today. PMID: 32240092 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - April 3, 2020 Category: General Medicine Tags: Perm J Source Type: research

The Doctor's Day Off: An Encounter with Homelessness and Drug Addiction.
Authors: Bachhuber S PMID: 32213275 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - March 29, 2020 Category: General Medicine Tags: Perm J Source Type: research

Challenging the Surgical Axiom: Albumin Level Does Not Reliably Predict Development of Wound Complications in Patients Undergoing Body Contouring.
CONCLUSION: Albumin values were not associated with wound complications or need for reoperation in patients undergoing body contouring. Further research is warranted. PMID: 32097112 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

Evolving Treatment of Frontal Sinus Cholesteatoma: A Case Report.
DISCUSSION: The pathogenesis of frontal sinus cholesteatoma varies based on its cause (congenital vs acquired). Clinical diagnosis remains challenging but is aided by nasal endoscopy, computed tomography, and magnetic resonance imaging. Historically, FSC has been managed by total extirpation through open approaches, which can entail substantial morbidity. With sophisticated endoscopic sinus instrumentation and image guidance, FSC can be successfully treated via an endoscopic approach. Serial débridements and washouts in an outpatient setting may adequately manage the residual disease in the postoperative period. ...
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

Primary Breast Carcinoma of the Vulva Metastatic to Lymph Nodes and Bones: A Case Report and Literature Review.
DISCUSSION: For a diagnosis of primary breast cancer of the vulva, a thorough metastatic workup should be performed, with attention directed toward detecting a breast primary disease by results of the history, physical examination, and radiologic examination of the breasts mainly to help confirm that the vulvar lesion is the primary site as opposed to metastasis from a breast primary cancer and also for staging. Management of this rare entity is challenging because of a lack of specific guidelines, and treatment, therefore, is similar to that of breast cancer.Treatment should consist of an individualized combination of sur...
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

Prostate Cancer and Asbestos: A Systematic Review and Meta-Analysis.
CONCLUSION: Patients who were exposed to asbestos should possibly be encouraged to complete more frequent prostate cancer screening. PMID: 32097115 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

Immunotherapy Outcomes in Advanced Melanoma in Relation to Age.
CONCLUSION: Aging does not seem to affect response to checkpoint inhibitors. Elderly patients with metastatic melanoma should be treated similarly to younger patients. PMID: 32097116 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

Effects on Medical Students of Longitudinal Small-Group Learning about Breaking Bad News.
CONCLUSION: The activities offered helped students develop communication skills. They made connections between their formal training (communication and cognitive skills) and actual clinical practice in a community-based rotation. The knowledge and skills acquired gave them tools needed to deliver bad news in their future clinical practice. PMID: 32097117 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

MD Aware: A Mindful Medical Practice Course Guide.
Authors: Dobkin PL PMID: 32097118 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - February 26, 2020 Category: General Medicine Tags: Perm J Source Type: research

Adverse Childhood Experiences (ACEs) and Community Physicians: What We've Learned.
Authors: Stork BR, Akselberg NJ, Qin Y, Miller DC Abstract INTRODUCTION: The prevalence of childhood trauma, as measured by the Adverse Childhood Experiences (ACE) Study questionnaire, has been studied in a wide variety of community settings. However, little is known about physicians' familiarity with and use of the ACE questionnaire or the prevalence of childhood trauma in the physician community. OBJECTIVE: To survey a convenience sample of community-based physicians and resident physicians to assess for familiarity with and use of the ACE questionnaire in clinical practice and to measure the prevalence of th...
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Association Between Peripheral Blood Oxygen Saturation (SpO2)/Fraction of Inspired Oxygen (FiO2) Ratio Time at Risk and Hospital Mortality in Mechanically Ventilated Patients.
CONCLUSION: The SF-TAR can identify ventilated patients at increased risk of death, offering modest improvements compared with single SpO2/FiO2 and P/F ratios. This longitudinal, noninvasive, and broadly generalizable tool may have particular utility for early phenotyping and risk stratification using electronic health record data in ventilated patients. PMID: 32069205 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Mixed Serous and Clear Cell Adenocarcinoma of the Ovary Presenting with Symptomatic Hypercalcemia: A Case Report and Clinical Considerations.
DISCUSSION: Hypercalcemia is a rare but possible primary presenting symptom of ovarian cancer. In these patients, serum calcium measurements could possibly serve as a tumor marker for disease. PMID: 32069206 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Identifying Patients with Rare Disease Using Electronic Health Record Data: The Kaiser Permanente Southern California Membranous Nephropathy Cohort.
DISCUSSION: Our findings suggest that ICD-9 diagnosis codes might be a convenient tool to identify patients with MN using EHR and/or administrative claims information. Codes selected from supervised learning achieved better overall performance, suggesting the potential of developing data-driven methods. PMID: 32069207 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

A Novel Instrument for Integrated Measurement and Assessment of Intrinsic Motivation, Team Climate, and Burnout in Multidisciplinary Teams.
CONCLUSION: The study fills a gap in the health services research literature pertaining to the performance of multidisciplinary teams. PMID: 32069208 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Negative-Pressure Wound Therapy to Reduce Wound Complications after Abdominoperineal Resection.
DISCUSSION: Additional, prospective research is needed to confirm the benefit of prophylactic incisional NPWT. PMID: 32069209 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Haiku and Healing-Creating Connections.
Authors: Stork B PMID: 32069210 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Novel use of Apple Watch 4 to Obtain 3-lead Electrocardiogram and Detect Cardiac Ischemia.
Authors: Gil MÁC PMID: 32069211 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Awareness of Heterotopic Ossification in Total Joint Arthroplasty: A Primer.
Authors: Lespasio MJ, Guarino AJ Abstract Heterotopic ossification (HO) is the presence of normal bone in soft tissue where bone should not exist. After direct musculoskeletal trauma of the surrounding soft tissue, HO is hypothesized to develop from a dysfunction of normal lamellar bone formation and remodeling that appears in nonskeletal areas of the body. Acquired HO related to total joint arthroplasty (TJA) of the hip and knee forms outside the joint capsule and can be a challenging condition when it impairs the essential healing process after elective surgery. Although HO is rare after elective TJA and thus cli...
Source: The Permanente journal - February 20, 2020 Category: General Medicine Tags: Perm J Source Type: research

Novel Antiplatelet Perioperative Bridging Protocol for Lung Lobectomy: A Case Report.
We describe the novel addition of ticagrelor (a short-acting oral antiplatelet agent) to eptifibatide (a short-acting intravenous antiplatelet agent) to bridge DAPT for surgery. DISCUSSION: This ticagrelor-eptifibatide perioperative bridge resulted in decreased preoperative hospitalization compared with eptifibatide alone. There were no associated perioperative cardiac or bleeding complications. PMID: 31926566 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

Minimally Invasive Repair of Pediatric Morgagni Hernias Using Transfascial Sutures with Extracorporeal Knot Tying.
CONCLUSION: Morgagni hernias are amenable to minimally invasive repair with this simple technique. With large defects, synthetic patches should be used. Recurrences are rare, and morbidity is low. PMID: 31926567 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

A 10-Year Analysis of 3693 Craniotomies during a Transition to Multidisciplinary Teams, Protocols, and Pathways.
CONCLUSION: Multidisciplinary teams, protocols, and pathways reduced craniotomy complication rates, improved hospital length of stay by 63%, reduced costs, and increased professional collegiality and satisfaction. A searchable craniotomy discharge summary is an important tool for continuous monitoring of quality and efficiency of care. PMID: 31926568 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

Abdominal Aortic Aneurysm: A Case Report and Literature Review.
DISCUSSION: A literature review of proper screening, referral timeframe, the most common surgical techniques, potential complications, and postoperative surveillance was conducted. Early detection, referral to vascular surgery, and possible open or endovascular repair are key to limiting the morbidity and mortality associated with AAA. PMID: 31926569 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

Periodontal Diseases and Age-Related Macular Degeneration: Is There a Link? A Review.
CONCLUSION: According to the studies included in this review, periodontal disease may be a plausible risk factor for AMD and may have a potential role in the earlier stages of this eye disease. Further studies should be encouraged for better understanding of this potential new relationship. PMID: 31926570 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

Spontaneous Coronary Artery Dissection: Clinical Characteristics, Management, and Outcomes in a Racially and Ethnically Diverse Community-Based Cohort.
CONCLUSION: The study cohort is comparable to published SCAD cohorts, but notable for a racially and ethnically diverse population. Compared with the controls, only pregnancy and hyperlipidemia were associated with SCAD. For the SCAD cases, major adverse cardiovascular events occurred in 8.1%, and race did not influence outcomes. PMID: 31926571 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

911 Emergency. What Is Your Emergency and Location? My Road to Mindfulness.
Authors: La Borie P PMID: 31926572 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research

Poststreptococcal Reactive Arthritis: Diagnostic Challenges.
Authors: Chun C, Kingsbury DJ Abstract Poststreptococcal reactive arthritis (PSRA) is associated with prior group A β-hemolytic streptococcal infection and has a reported annual incidence of 1 to 2 cases per 100,000 persons, approximately twice that of acute rheumatic fever (ARF) in the US. Children who present with reactive arthritis are not uncommon in a busy general pediatric practice in the US, whereas children who present with ARF are very rare. Distinguishing PSRA from ARF can be challenging because the symptoms and signs are similar, but the diseases differ in long-term therapy, follow-up evaluation, an...
Source: The Permanente journal - January 14, 2020 Category: General Medicine Tags: Perm J Source Type: research